Southern
Domestic Partner Policy
Statement of Domestic Partnership
Procedures
The following information is provided with this packet:
Southern
Statement of Domestic Partnership
Termination of Domestic Partnership
Domestic Partner Health Insurance Premium Reimbursement Program Information
Health and Dental Premium Reimbursement Claim Form
All forms are available on the Human Resource’s website at http://www.siu.edu/~humres/html/forms.html.
Southern
Attached is the university’s policy which states the
benefits afforded to domestic partners.
These policies can be found on-line in the Employee Handbook at http://www.siu.edu/~docedit/employees_handbook/index.html.
Statement of Domestic Partnership Form
Employees who wish to be considered for use of the Domestic
Partner Benefit Program must complete this confidential form and submit it to
Termination of Domestic Partnership
If there is a change in your domestic partner status, the employee should notify Human Resources within thirty (30) days of such change by filing the Termination of Domestic Partnership.
Health, Dental & Vision Benefits
Health, dental and vision benefits will be extended to same-sex domestic partners under the State of Illinois Group Insurance Program in accordance with applicable state and federal laws. Benefit and enrollment information can be found at www.benefitschoice.il.gov.
Domestic Partnership Identification Card
Upon request, a Domestic Partner ID card will be issued to
eligible domestic partners of employees of SIUC. The ID card can be used to gain access to
select university facilities and services, such as Morris Library,
Questions? Contact Employee Benefits at 453-6668.